Intro Flashcards
“young” old*
65-74 yo
“middle” old*
75-84 yo
“old” old*
> /85 yo
cardiovascular system changes
↓ contraction and filling capacity, ↑ stiffness, atherosclerosis, ↓ valves, thrombosis/PE
CNS changes
↓ rate of conduction and strength of transmission, threshold for arousal blurred, ↓ adaptation, ↑ recovery time
respiratory system changes
Normal at rest, compromised under stress
↓ expiration, ↓ elasticity, muscle weakness, ↓ ventilation and PaO2
genitourinary (kidney) changes
nephron degeneration, ↓ renal blood flow, ↓ ability to concentrate urine, ↓ acid-base adaptation
diseases and problems with aging kidneys
inadequate fluid intake, fluid loss, shock, cardiac failure, sepsis, injudicious use of diuretics
genitourinary (bladder) changes in women
estrogen deprivation, atrophy, ↓ secretions, dyspareunia, urinary incontinence
genitourinary (bladder) changes in men
↓ testosterone, ↓ libido and energy, ↓ muscle mass, ↓ body hair, ↑ body fat, BPH, erectile dysfunction
gastrointestinal changes
↓ motility in esophagus and colon, ↓ stomach acid, ↓ liver size and blood flow, ↓ pancreatic secretions
musculoskeletal changes
atrophy, ↓ O2, joint erosion and degeneration, calcification of ligaments, osteoporosis & kyphosis, fractures and falls
skin and dermatology changes
↓ elasticity and turgor, ↑ pigmentation
sensory changes
↓ vision and hearing
geriatric definition
diminished homeostatic reserve capacity of all organ systems called homeostenosis
geriatric syndromes definition
multifactorial health conditions that occur when the accumulated effects of impairments in multiple systems render a person vulnerable to situational changes
geriatric syndromes
● multiple risk factors and multiple organ systems are often involved
● diagnostic strategies to identify the underlying causes can be ineffective, burdensome and costly
● therapeutic management of s/s can be helpful in the absence of a diagnosis or underlying cause
geriatric syndrome examples
dementia, delirium, urinary incontinence, falls, pressure ulcers, polypharmacy, iatrogenesis
*differences between delirium and dementia
delirium: sudden onset, caused by another condition, reversible, worse at night, incoherent language, immediate need for medical attention
dementia: gradual, permanent, chronic brain disorder, impaired orientation, lost memory
frailty definition
reduced ability to maintain or regain homeostasis after a destabilizing event
frailty phenotype
● weight loss (>4.5 kg or >5% per year)
● self-reported exhaustion (3-4 days per week)
● low energy expenditure (<383m or <270w kcal/week)
● slow galt speed
● weak grip strength
medications and frailty
significant association, unclear and bidirectional
clinical geriatrics pearl
any symptom in an elderly patient should be considered a drug side effect until proven otherwise
comprehensive geriatric assessment
cost and coverage, adherence, safety, attaining therapeutic goals
